Monitoring & Evaluation Form

The City Bridge Trust Date Sent: 27-Mar-14 Charity Registration Number: 1035628 GO: KMG Monitoring & Evaluation Form Working with Londoners (Grants of £10,000+) Older Londoners

Name of Organisation in receipt of grant: Grant Reference: Bishop Creighton House 11230

Name & position of person completing form: Contact Tel No/E-mail: Joy Houghton-Brown 0207 385 9689 jhoughtonbrown@creightonhouse .org Original purpose of grant: £122,500 over three years (£40,250; £40,750; £41,500) for a full-time Volunteer Co-ordinator plus management and other costs of the Keep Active project.

1. Has the grant payment for the year been used in full?

2. If not, please explain why this is the case and when it is expected to be fully used:

3. Please provide the period of the grant awarded by the Trust. If the grant is/was for more than one year, please complete the relevant boxes below:

Year 1 Year 2 Year 3 FROM month year month year month year 4 2013 4 2014 4 2015 TO month year month year month year 3 2014 3 2015 3 2016

4. If your grant includes staffing costs, please confirm the name(s) of the postholder(s) and their start date: Miriam Baines 8.4.2013

5. Have you provided a copy of your most recent Annual Report, acknowledging support from the Trust, together with Audited Accounts covering the period during which the grant was used? Annual Report: No

Audited Accounts: No

6. If not, when will these be available? Annual Report: October 2014

Audited Accounts: October 2014

1 7. What were the key objectives of the work funded by the Trust? 1. To support isolated older and disabled people to get active and independent again after a fall or illness. 2. To recruit, train and support a team of volunteers to provide one-to-one encouragement and help in walking outside and exercising. 3. To work alongside staff in the Community Rehabilitation Service, complementing their professional care. 4. To create a working model for community health support, which could be replicated in other neighbourhoods.

2 8. Have you received any training in monitoring and evaluation?

If yes, who provided the training? Hammersmith and Fulham Community and Voluntary Sector Association (CAVSA): 19 April 2013

3 9. Please tell us how you have met your objectives.

 Use the monitoring information you have been collecting to describe the project’s outputs* and outcomes* making it clear you know how you have achieved your outcomes. * ‘Outputs’ are the quantifiable activities that your project has carried out in order to meet its objectives.

* ‘Outcomes’ describe the effects or impact of your project and the difference you have made to those with whom you have worked.

Your monitoring statistics and service user feed-back should help provide the information you need. If you are unsure about what information you should be collecting, please contact your Grants Officer.

1. Objective: To support isolated older and disabled people to get active and independent again after a fall or illness.

Outputs: 450 people in total (150 people each year over 3 years) supported through a 9 week recovery programme by our volunteer and staff team.

70 clients*, discharged from the Hammersmith & Fulham Community Rehab Service (hereon referred to as CRS), have been referred to the Keep Active Service and have received ongoing support through the Keep Active 9 week recovery programme. Keep Active volunteers have given 622 hours of support to clients.

* This figure is lower than the target of 150 clients given in the funding outputs due to this being a pilot first year, and for the reasons given under Objective 3 below.

Outcome: Improved mobility, physical health and mental wellbeing for older people with a disability or poor health.

 In a follow-up questionnaire, 96% of clients reported feeling healthier and more confident with the exercise programme/goal the CRS had given them following the volunteer support.  Keep Active achieved this outcome through close partnership working with CRS. Physiotherapists and occupational therapists identified patients that were due to be discharged, but who could benefit from more support with their goals. These clients were questioned before and after the volunteer support to assess the difference the volunteer support had made and how it had impacted their health and confidence.  There was an increase in health and confidence in 96% of the clients.  At the beginning of the volunteer support, physiotherapists and occupational therapists graded the client’s ability with the goal set according to a rating from -2 to +2. At the end of the session the clients were graded again and an increase in this score was seen in 91% of cases.  Additional evidence of wellbeing was shown in that 98% of the clients questioned said they felt happier when their volunteer visited them and 39% of clients were referred onto other support services within their community which gave them further opportunities for social interaction and promoted mental wellbeing.

Please see Appendix 2:Client Stories & Appendix 3: Quotes from Clients

4 5 2. Objective: To recruit, train and support a team of volunteers to provide one- to-one encouragement and help in walking outside and exercising.

Outputs: 150 volunteers recruited over three years; Bi-monthly training sessions provided from CRS; Bi-monthly volunteer meetings, quarterly steering group and ongoing support/supervision.

 In the first year we recruited 69 volunteers between the ages of 18 and 75

 6 Bi-monthly training sessions have been provided by CRS and Keep Active. 69 Volunteers received high quality training by CRS staff (eg, Physiotherapist, Occupational Therapist and Community Rehab Assistant). In addition to this we provided 6 Bishop Creighton House Volunteer Induction training sessions which all 69 volunteers attended so that they were familiar with our policies and procedures relating to good practice, personal safety and home visits. 98% of the volunteers scored the training as ‘excellent’.

 6 external, specialist training sessions were offered to Keep Active volunteers eg, Heart start training (British Heart Foundation) Alcohol Abuse (H&F Older People’s Alcohol Service) Dealing and Coping with Loss (K&C Cruise)

 6 Bi-monthly volunteer support meetings/volunteer social events were offered in partnership with Homeline’s volunteer support programme.

 Ongoing support/Supervision: 35 support and supervision sessions were given to volunteers by Keep Active staff during the process of monitoring the outcomes of our 9 week interventions. At these meetings volunteers talked through what went well, any difficulties and their future plans.

 Quarterly steering group: Keep Active staff met with CRS on a quarterly basis and 5 meetings have taken place. The next scheduled meeting (April 2014) will also be attended by a client and volunteer.

Outcome: Local people of all ages provided with a rewarding and meaningful volunteering experience, with training and support from physiotherapists.

 Volunteers received high quality training by Keep Active staff as well as CRS staff (eg, Physiotherapist, Occupational Therapist and Community Rehab Assistant).  After interview, the volunteers were matched with clients. The volunteers’ and clients’ interests and hobbies were taken into account and individuals were matched accordingly to increase the chances that their volunteer experience would be rewarding and meaningful.  Volunteers were made aware that any queries or problems that immerged during their visits with the clients could be fed back to staff at Keep Active who in turn raised this with the physiotherapist or occupational therapist who referred the client.  Keep Active staff liaised between the volunteer and therapist ensuring that the volunteer felt that they could get support and advice from the Rehab team once they were doing the home visits on their own.  As a consequence of their excellent volunteering with Keep Active one volunteer has now been offered a permanent Rehab Assistant post with Hammersmith & Fulham CRS.

Please see Appendix 4: (Quotes from Volunteers) for quotes from volunteers over the first year of Keep Active.

6 3. Objective: To work alongside staff in the Community Rehabilitation Service, complementing their professional care.

Outputs: 450 ongoing cases (150 per year) from the community rehabilitation service discharged (into Keep Active)

In Year One Referrals have been coming from Community Independence Reablement Service (CIS) , Community Rehab Unit (CRU)(Bedded High Dependency patients) and Community Rehab Service (CRS)

In year One a total of 70 patients* were discharged into the Keep Active Service. The breakdown of referrals was as follows: CRU: 0 CIS: 6 CRS: 64

*Reasons for Keep Active referrals being lower (i.e. 70 not 150 per year):

CRU:  Although wanting to refer into Keep Active we have actually received no referrals from CRU to date due to much higher dependency of patients who would often returning home with significant packages of care and needs not suited to Keep Active volunteers.  Major staffing issues with many posts filled by short-term ‘locum’ staff unfamiliar with Keep Active.  CRU will remain a potential source for a low number of referrals. CIS:  Major staffing issues with key staff having left during the year and replaced currently by locum staff who have now also moved on.  Understaffing and high waiting lists have meant CIS only focusing with short term cases.  CIS take full responsibility for the low rate of referrals: Sarah Teague, Clinical Lead: falls and bone health (CLCH NHS TRUST) ”CIS has had to narrow their inclusion criteria temporarily to see only urgent 'rapid response' referrals not requiring rehabilitation work” March 2014 CRS:  Major restructuring of staff meaning vacancies within the team, backfill by agency staff and high agency staff turnover leading to loss of knowledge about local services and resources  CRS team members having less time to induct new staff to the specifics of Keep Active Service nor to ensure a constant stream of referrals was maintained.  Sarah Teague March 2014 quotes “ It is highly likely, due to changes to the structure of CRS as a result of clinical restructure and increased demands on the clinicians as a result of resource limitation, that the 150 referrals per year proposed in the Keep Active Business Case was an over estimation. However, with the vacant posts filled and the leadership of Keep Active within CRS optimised via staff induction and referral monitoring, it is reasonable to expect 100 referrals per year going forward into year 2 of the project.”

7 Outcome: Reduced pressure and more capacity to concentrate on acute cases for the Community Rehab Service;

In our recent Steering Group (13/3/2014) with CRS, Senior staff stated that Keep Active had reduced pressure by enabling staff to move their focus to more acute cases. Sarah Teague quoted March 2014 “Early discharge of low need clients where staff felt the Keep Active volunteer could meet the client requirements has freed up staff time for more urgent cases.” CRS are also undertaking running a report to show the average length of treatment (in number of direct contacts) and to show these clients have not been referred back into H&F CRS since discharge from the service

Outcome: Reduced hospital re-admissions following falls or illness.

This data is not currently available (ie for the 2013-14 reporting year) because of information governance legislation preventing the sharing of client level data. However, a new 2014-16 NHS partnership agreement should allow for the sharing of information about clients who have been admitted to hospital and should mean that during year 2 (ie 2014-15 reporting year) Keep Active should be able to demonstrate fewer admissions amongst those referred to Keep Active during intervention period and in the 3-6 months post discharge. “However (we quote Sarah Teague) It must be acknowledged that admission to hospital may not be a sensitive measure of effectiveness of the Keep active model in consideration of the client group seen by the volunteers i.e. those who are the oldest clients, with multiple long term conditions/diagnosis, frailty and complex needs. An acute admission in this client group (and the prevention of one) will be dictated by many variables over and above Keep Active input e.g. medical deterioration/disease progression.”

• In your application you said you would meet the following outcomes of the Trust: More over 75's living healthier and more active lives.

Your report should also describe how you met our outcome(s) and how you know you have achieved this.

• Where appropriate, we would like to see a summary of your monitoring statistics and feedback from those with whom you have worked.

How we met your outcome: More over 75's living healthier and more active lives:  The Keep Active project has enabled 70 older people discharged from CRS, to receive 622 hours of continued support with their goals: indoor exercises, mobility, accessing the community, domestic tasks and communication practice.  In a follow-up questionnaire, 96% of clients reported feeling healthier and more confident with the exercise programme/goal CRS had given them following the volunteer support.  Keep Active achieved these outcomes through close partnership working with CRS. Physiotherapists and occupational therapists identified patients due to be discharged, but who they felt could benefit from more support with their goals.

How we know we have achieved this:  All clients were questioned before and after the volunteer support to access the difference the volunteer support had made and how it had impacted their health and confidence. There was an increase in health and confidence in 96% of the clients.  At the beginning of the volunteer support, the physiotherapists and occupational therapists graded the client’s ability with the goal set according to a rating from -2 to +2. At the end of the session the clients were graded again and an increase in this score was seen in 91% of cases.  98% of the older people questioned after their volunteer support said they felt happier when their volunteer visited them and 39% of clients were referred onto other support services within their community which gave them further opportunities for social interaction and promoted mental wellbeing. Please see Appendices 3, 4 and 5 for feedback from clients, volunteers and professionals with whom we have worked. 8 4. Objective: To create a working model for community support which can be replicated in other neighbourhoods

Outputs: Project piloted in Hammersmith and Fulham, providing a replicable model and case studies for providers in other boroughs.

This year Keep Active and CRS have developed and piloted the Keep Active model. The project has been shown to be simple, efficient and effective and well-liked by both clients and volunteers. Appendix 1 refers to this model.

Central London Community Healthcare short-listed H&F CRS this year as ‘Team of the Year’ for partnership working (Keep Active being the partnership). CRS are also putting forward their team forward for a “Quality Team” award showcasing innovative work. Again Keep Active is the ‘innovative work’.

CRS have asked Keep Active during year 2 (2014/15) to show how Bishop Creighton House could roll out the Keep Active model throughout the Tri-Borough of H&F, Kensington & Chelsea and Westminster. This could include using partnerships with other voluntary bodies and securing NHS or other funding for this expansion.

Outcomes: Replicable model for community-based mobility support created and tested; Positive outcomes of project benefit older people across large geographical area

Keep Active is seen by CRS as a highly replicable model. The first year has shown that outputs for numbers of referrals were set too high at 150 per year but if that is reduced to a manageable 100 per year then there is no reason why the model of partnership with NHS and voluntary Sector can’t be rolled out across at least the Tri-Borough (H&F, K&C and Westminster) in the first instance. Sarah Teague (March 2014) stated ‘The NHS seeks standardised levels of care and services across the Tri-Borough and Keep Active’s simple but effective model should be easily expandable’.

9 10. Did the objectives change? NO

11. If yes, please describe below:

10 12. What have you learnt from this piece of work?

 What went particularly well/was especially effective?

The fact that the Keep Active project is managed by Bishop Creighton House (BCH) has bought many advantages to the project making it work well and be effective.

 BCH has a well-established befriending service for isolated older people called ‘Homeline’. This meant there was a group of pre-existing volunteers keen to get involved with Keep Active from day one. Homeline and Keep Active continue to work closely together on volunteer recruitment.

 Staff at Keep Active and Homeline worked closely, co-ordinating and delivering Volunteer Induction Training Sessions to volunteers together. This meant that within weeks of the project starting, there was a group of trained volunteers ready to volunteer for Keep Active.

 The Keep Active project sits alongside ‘Homeline’ and this means that if Keep Active staff identify further support needs in their clients, these clients can be referred on to Homeline, ensuring they have a long-term continuation of support after Keep Active sessions come to a close.

 BCH was able to obtain £10,000 from The Mercers Company in October 2013 so that Keep Active’s clients could access BCH’s other services specifically Safer Homes and Homeline.

 Through the Mercer’s funding Keep Active clients have been able to access Homeline’s Telephone Befriending and be invited to their monthly lunches and events. Fifteen Keep Active clients have chosen to get involved in these Homeline services and through this have increased their social interaction and wellbeing. One client explained it like this: ‘Because of Keep Active I now come to the monthly lunches every month, (I still) see the volunteer who used to visit me and catch up with her, I look forward to them’. MF 25/2/14.

 BCH has a safety check and handyman service for over 60’s called ‘Safer Homes’. When Keep Active staff visit clients they can identify clients who have a safety issue in their home. Through the Mercer’s funding (as in para above) Eight Keep Active clients have benefitted from this free service and have had safety maintenance work done such as, trip hazards fixed, additional safety locks fitted, fire alarms tested and carbon monoxide alarms fitted.

 The way the Keep Active project has worked alongside the other projects at BCH has made it especially effective because clients have benefitted from a range of services, depending on their need. This has ensured they are offered holistic, long term support, which is sustainable and tackles other issues alongside their physical health and wellbeing.

Are any aspects of your work replicable?

11 Please give details below.

The outcome for Objective 4 includes Keep Active being a ‘Replicable model for community-based mobility support’.

See here the answer to that question:

Keep Active is seen by CRS as a highly replicable model. The first year has shown that outputs for numbers of referrals were set too high at 150 per year but if that is reduced to a manageable 100 per year then there is no reason why the model of partnership with NHS and voluntary Sector can’t be rolled out across at least the Tri-Borough (H&F, K&C and Westminster) in the first instance. Sarah Teague (March 2014) stated ‘The NHS seeks standardised levels of care and services across the Tri-Borough and Keep Active’s simple but effective model should be easily expandable’.

We will seek to explore further how to move towards possible replication of the Keep Active model. CRS have asked Keep Active during year 2 (2014/15) to show how Bishop Creighton House could roll out the Keep Active model throughout the Tri-Borough of H&F, Kensington & Chelsea and Westminster. This could include using partnerships with other voluntary bodies and securing NHS or other funding for this expansion.

 What did not go as well/was challenging?

The aspect which has been most challenging in this first year of Keep Active has been the fact that referrals have been much slower/ lower than expected.

The nature of this project meant that from the beginning we were limited with H&F CRS being our only source of referrals. When we applied for the funding we worked closely with them in drawing up the bid and they felt confident at the time that they would be able to give us at least 150 referrals a year.

However, due to the reasons outlined above in Question 9 Objective 3 ‘Outputs’ Keep Active only received 70 referrals this year. Sarah Teague March 2014 quotes “ It is highly likely, due to changes to the structure of CRS as a result of clinical restructure and increased demands on the clinicians as a result of resource limitation, that the 150 referrals per year proposed in the Keep Active Business Case was an over estimation. However, with the vacant posts filled and the leadership of Keep Active within CRS optimised via staff induction and referral monitoring, it is reasonable to expect 100 referrals per year going forward into year 2 of the project.”

In agreement with CRS we therefore wish to ask for our outputs for Objective 1 ‘450 people in total (150 people each year over 3 years) supported through a 9 week recovery programme by our volunteer and staff team’ reduced in year 2 and 3 to ‘270 people in total (100 per year, 70 in year 1) supported through a 9 week recovery programme by our volunteer and staff team’

We also wish to have outputs for Objective 3 reduced from ‘450 ongoing cases (150 per year) from the community rehabilitation service discharged (into Keep Active)’ to ‘270 ongoing cases (100 per year, 70 in year 1) from the community rehabilitation service discharged (into Keep Active)’.

12 13. Has the grant contributed to your organisation’s development? If so, please describe, including any benefits it has brought to your organisation beyond financial ones.

The City Bridge grant has enabled BCH to work in close partnership with the NHS (CRS). We believe this has helped shape their perception of the Voluntary Sector and the value it offers. As can be seen from the comments from Sarah Teague in the questions above the NHS are realising through partnerships such as Keep Active the quality and value the voluntary sector offer.

13 14. Have there been any substantial changes in your organisation since the grant was made (e.g. key personnel, management committee members, funding, premises)? If so, please give details:

15. What further steps has your organisation taken to reduce its carbon emissions?

 Both Manager and Co-ordinator for Keep Active have used bicycles when travelling around the borough for Keep Active. This has reduced costs and carbon emissions.  Recycling is being increased with better sorting of waste.  Our Mentoring project has funding for a gardening project which looks after our small garden and this includes improving the habitat for wildlife.

16. Is this project or activity to continue after the Trust’s funding has come to an end?

17. If so, how will it be funded?  See the answer to question 12 above: ‘Are any aspects of your work replicable?’  CRS have told us they will consider seeking NHS funding in January /February 2015 to trial ‘rolling out’ the Keep Active programme to the Tri-Borough.  We will also work closely with CRS to see if we can demonstrate that hospital re- admissions have been reduced. This involves a fair amount of anonymous data checking between Keep Active/CRS and CLCH. (See also answer to Question 9, Objective 3 Outcome: Reduced hospital re-admissions following falls or illness).  Both these efforts (demonstrating reduction of hospital admissions and roll out to Tri- Borough) should mean it will be possible to gain at least some NHS funding of Keep Active.  We are confident that if we obtain at least partial NHS funding it will enable us to be successful in securing match funding from elsewhere.

18. How many people have benefitted from this grant in this year?

14 19. Has this grant had an effect on your other fundraising results?

20. If it has been helpful, please give details:

We have been successful in a small grant application for £10,000 from The Mercers Company for one year. This money has been shared between 3 BCH projects (Homeline, Keep Active and Safer Homes) to help Keep Active clients benefit more fully from the services of Bishop Creighton House. Keep Active received £4116 which helped cover a small deficit in the budget. Homeline received £3458 which helped to fund ongoing telephone befriending calls to Keep Active clients and Safer Homes received £2426 for providing home safety checks and handy man visits to Keep Active clients.

15 21. What are your key activities for the work funded by the Trust over the coming Year?

1. To support isolated older and disabled people to get active and independent again after a fall or illness. Outputs: 270 people in total (100 per year, 70 in year 1) supported through a 9 week recovery programme by our volunteer and staff team Outcomes: Improved mobility, physical health and mental wellbeing for older people with a disability or poor health.

2. To recruit, train and support a team of volunteers to provide one-to-one encouragement and help in walking outside and exercising. Outputs: 150 volunteers recruited over three years; Bi-monthly training sessions provided from CRS; Bi-monthly volunteer meetings, quarterly steering group and ongoing support/supervision. Outcome: Local people of all ages provided with a rewarding and meaningful volunteering experience, with training and support from physiotherapists.

3. To work alongside staff in the Community Rehabilitation Service, complementing their professional care. Outputs: 270 ongoing cases (100 per year, 70 in year 1) from the community rehabilitation service discharged (into Keep Active). Outcome: Reduced pressure and more capacity to concentrate on acute cases for the Community Rehab Service; Reduced hospital re-admissions following falls or illness.

4. To create a working model for community health support, which could be replicated in other neighbourhoods. Outputs: Project piloted in Hammersmith and Fulham, providing a replicable model and case studies for providers in other boroughs. Outcomes: Replicable model for community-based mobility support created and tested; Positive outcomes of project benefit older people across large geographical area

22. Are there any factors envisaged, internal or external that would affect the future viability of the project over the coming year?

Nothing other than outlined in question 9 objective 3 above which explains the external factors within the CRS which had meant fewer referrals in year 1 than expected when the funding was applied for. Keep Active has prospered despite these factors (eg, CRS staffing shortages and changes). We expect the staffing situations within CRS, CRU and CIS to improve during 2015 and have built in plans together with them to overcome these factors such as attending staff meetings on a monthly basis and attending community clinics on a regular basis to collect referrals when needed. Question 21 shows how we have amended our referral numbers for the coming year to reflect this situation.

16 23. How have you found your dealings with the Trust?

Excellent

24. Please provide any comments you have about your dealings with the Trust including any problems you may have encountered:

Staff have been most helpful on the telephone and have always been very clear and concise in any correspondence.

17 25. Please complete the following financial breakdown for the project or activity that was funded by the Trust. This should refer only to the year covered by this report.

Expenditure £ Capital

New buildings/refurbishment

Office equipment including computers

Vehicle purchase

Furniture or play equipment

Total Capital Costs

Revenue

Salaries of staff 34022

General running expenses 8560

Training for staff and volunteers 820

Consultancy and advice

Total Revenue Costs 43402

UNSPENT GRANT

Total Grant Awarded 40250

If you have any photographs illustrating the work funded by the Trust, we would be interested to have copies. Please indicate if you give permission for the photographs to be used for our own publicity purposes

To the best of my knowledge, all the information that I have provided in this form is correct.

Signature of person completing form:......

Position Held: Manager Keep Active......

Date: ...... 27 March 2014...... Photographs can be used: Yes

18 Concerns over Fraud and Corruption

Should you at any time have concerns of fraud and corruption within your organisation then please raise your concerns with us by using our Whistle Blowing facilities. You may use Audit’s 24 hour answer phone number 0207 332 3663 or email. [email protected]

Thank you for completing this form. Please could you return it to:

To claim the next instalment of your grant (if  The City Bridge Trust applicable) City of London We need to receive from you: PO Box 270 A payment request form or letter requesting payment Guildhall signed by your Chair or Treasurer London EC2P 2EJ Your organisation’s income/expenditure budget for the current financial year Your most recent management accounts  020 7332 3710 Please enclose these items when you send us  www.citybridgetrust.org.uk your form

Please note that we do not accept monitoring forms by fax or e-mail

19 The City Bridge Trust office use only

Satis- Very Poor Good factory good 1. Met their objectives: □ □ □ □ 2. Quality of monitoring statistics: □ □ □ □ 3. Quality of user feed-back: □ □ □ □ 4. Impact of the work: □ □ □ □ 5. Efforts to reduce carbon footprint □ □ □ □ Trust’s outcomes: 6. 05. Older Londoners,a) More over 75's living healthier and more active lives □ □ □ □

Photographs enclosed: YES / NO

Monitoring visit: YES / NO

General comments:

Grants Officer initials: Date: